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VIDEO: RE-CIRCUIT results on uninterrupted dabigatran in AF ablation poised to change practice
WASHINGTON — In this Cardiology Today video perspective, Jagmeet P. Singh, MD, PhD, associate chief of the cardiology division at Harvard Medical School in Boston, highlights positive findings on uninterrupted anticoagulation with dabigatran among patients undergoing atrial fibrillation ablation in the RE-CIRCUIT study.
“The study really highlights two important things,” he said. “One is that the old notion of using anticoagulation periprocedurally through an AF ablation is actually safe. The second is that dabigatran, which is a thrombin inhibitor, actually works pretty well.”
Singh discusses the major bleeding events seen with the nonvitamin K oral anticoagulant dabigatran (Pradaxa, Boehringer Ingelheim) vs. the conventionally used vitamin K agonist warfarin, then broadens the conversation to include findings on the Factor Xa inhibitor rivaroxaban (Xarelto, Janssen Pharmaceuticals) vs. warfarin from the VENTURE-AF study.
He goes on to note some adverse events and related drug discontinuation rates in the dabigatran group but also considers the promise that a corrective course for bleeding carries.
“Having [the antidote to dabigatran] obviously does provide some level of comfort to conventional AF ablation procedures, especially if you’re having periprocedural anticoagulation on board,” Singh said. “Overall, it’s a really good study, and I think it will impact practice.”